How to Help Someone with Dissociative Identity Disorder (DID)

Living with someone who has dissociative identity disorder

If your loved one has dissociative identity disorder (DID)—sometimes known as multiple personality disorder or split personality disorder—their condition can have a drastic effect on almost every aspect of their life.

The most prominent symptom of DID involves “switching” between alters, or different identities. At times, your loved one could take on a child-like persona; other times, they might seem like an irritable and rebellious teen. Alters are actually all part of a single, fragmented personality, but when one of them takes control, the change in your loved one’s attitude and behavior can be disconcerting.

Even if they don’t fully switch, a person with DID could wrestle with numerous voices in their head. They may also struggle with memory lapses, which in itself can make it difficult to function day to day.

Unsurprisingly, this can take a toll on a person’s relationships. You might find it hard to rely on your loved one, or maybe you constantly feel on edge, as if an emergency is always right around the corner. You may also fear that a sudden switch will upend your plans or lead to an embarrassing incident in public.

Know that your loved one is also in distress. They likely feel shame and helplessness over their symptoms. In addition, dissociative identity disorder is often the result of intense childhood trauma that they’ve endured. Your support and patience can go a long way in helping them cope with their condition and regain a sense of control over their life.

Helping someone with DID tip 1: Equip yourself with knowledge

Dissociative identity disorder is a complex and often misunderstood condition. So, the first step in helping your loved one is to develop a more thorough understanding of what they’re going through.

Learn as much about dissociative identity disorder as you can. Read books, listen to podcasts, and watch videos by experts and people with the disorder. You might also consider looking into the other dissociative disorders—dissociative amnesia and depersonalization disorder. A person with DID may experience symptoms of these other two conditions as well.

[Read: Dissociate Identity Disorder (DID) What It Is, Symptoms, Treatment]

Ask your loved one about their experiences. Keep in mind that DID symptoms can vary in severity from person to person. Even if you read a lengthy book about the condition, not everything in it will apply to your loved one’s experiences. Rather than assume you know what their life is like, take time to be curious and ask them questions.

Know what to do in an emergency. Studies indicate that people with DID are often at increased risk of self-harm and suicide attempts. With that in mind, it’s important to know what to do if someone you love is feeling suicidal. Knowing the warning signs and having a plan may save their life. Read: Suicide Prevention.

Tip 2: Provide social support

People with DID often feel alone in their struggles. They may isolate themselves or be hesitant to open up due to shame or embarrassment. However, isolation only worsens mental health, deepening issues like anxiety and depression. To avoid this, offer your loved one reliable social support.

Ask them what they need. Maybe they simply need someone to listen rather than provide advice. If that’s the case, listen without jumping in with opinions or suggestions. Just make it your goal to understand. Or your loved one may simply want a partner for a mindful walk in the park.

Share what you need. Don’t forget that they have much to offer your relationship as well. Asking them for help can make them feel like your relationship is a balanced “give and take.”

Respect their boundaries. From memory loss to the actions of alters, the past can be a source of stress and uncertainty for a person with DID. If they can’t recall something, don’t say things like, “Why can’t you just remember?” If they simply don’t want to talk about something, be willing to honor their privacy.

They have likely experienced past trauma, and you don’t want to pressure them to talk about their history before they’re comfortable. Similarly, don’t push them to talk about their alters if they’re hesitant or unwilling.

Enjoy life with them. Not every interaction has to relate to DID. If you have shared hobbies or interests, spend time embracing those pastimes. When possible, encourage your loved one to join you on new adventures. Remind them that, despite their condition, they can still live a full and meaningful life.

Tip 3: Be attentive to their present state

A switch can be jarring, unsettling, or occur at inconvenient times. In some cases, it may be the most disruptive symptom of DID.

Signs of switching may differ from person to person. However, once you notice it happening, it’s important to be flexible in your approach. Some signs can include:

• Looking “spacey” or suddenly confused or dizzy.
• Experiencing mild spasms.
• Blinking, as if to clear up blurry vision.
• A change in posture or vocal tone.
• Sudden forgetfulness, such as asking, “Where are we?” or “What was I saying?”

Know that even if a switch doesn’t occur, your loved one may experience other symptoms. For example, the voices in their head might get louder, or they might experience a sudden wave of derealization, during which they might look confused or “spaced out.”

Aim to interact with the person as they are in that moment. Respond to whatever they’re communicating. If they suddenly become upset or dramatic, stay calm and lend an ear rather than be combative. If they seem fearful, offer them comfort.

Steer them toward mindfulness. Mindfulness—a nonjudgemental acceptance of the present moment—can be particularly helpful to people with DID. One quick way to encourage mindfulness is to direct their attention to present sensations. Sway with them to music playing in the background. Ask them to describe the taste of the food they’re eating. Pause and do a breathing exercise together.

Tip 4: Help them identify triggers

Certain cues, or triggers, might cause a person with DID to switch or activate other symptoms. If you can work with your loved one to identify their triggers, you’ll both be better prepared to manage their switching.

Triggers can be related to things like:

• Time, such as holidays or other occasions.
• Places, such as locations of past trauma.
• Sensations, such as smells or sounds.
• Thoughts and feelings.
• Relationships, including interactions with certain people.

Encourage your loved one to keep track of potential triggers. For example, they might note where they were or how they were feeling before their last switch occurred. Help them keep tabs on these triggers.

Certain triggers might be easily avoidable. For instance, you might notice that walking past a childhood home is a cue for switching. Instead, simply take a different route. However, keep in mind that avoidance is just a temporary solution. Your loved one will eventually need to learn to cope with triggers and DID symptoms through a combination of self-help steps and therapy.

Tip 5: Encourage self-help strategies

Encourage your loved one to adopt self-help strategies to manage their condition. For example, having a routine, including a regular bedtime and meal times, can help reduce confusion when memory gaps occur.

Be a part of their schedule, if possible. Show up for regular coffee dates or go for daily walks with them. Be understanding if they can’t make it to a scheduled activity.

Help them try out different memory tools. These tools help them overcome sudden memory lapses that come with bouts of dissociative amnesia. From calendars to digital schedulers, offer some suggestions that might be useful and convenient to them.

Nudge them to stay connected. You don’t have to be their only source of social support. Whether it’s a support group or just a hobby meetup group, encourage your loved one to interact with others. Join them for a few sessions if your presence makes it easier for them to get started.

Tip 6: Recommend professional treatment

Professional treatment for DID tends to involve psychotherapy. Working with a therapist, your loved one can learn skills to manage their symptoms, address past trauma, and strengthen their sense of self.

People with DID often struggle with the following conditions as well, which may require additional treatment:

• Post-traumatic stress disorder. Because both conditions are rooted in trauma, many people with DID also struggle with PTSD.
• Eating disorders. Alters, trauma, or memory lapses can affect eating habits.
• Substance abuse. Your loved one may use drugs or alcohol to cope with stress or traumatic memories.

Not everyone is eager to seek out professional help, even if they’re struggling. When recommending therapy, avoid implying that your loved one is “crazy” or “out of control.” Instead, mention specific ways in which talking to a therapist may help them. For example, you might say, “A therapist can probably teach you a few strategies for managing those unpleasant switches.”

Tip 7: Take care of yourself

If you’re giving all of your time and attention to your loved one, you’re setting yourself up for burnout. Keep the following tips in mind to maintain your own physical, emotional, and mental health.

Tend to your physical needs. Maintain a regular sleep schedule, get plenty of exercise, and eat well. All of this can help you manage your stress levels.

Make time for your own hobbies, interests, and friends. Your entire life shouldn’t revolve around your loved one. Remember to make time for activities you personally enjoy and other people who form your social support network.

Know your limitations. For example, if your loved one seems resistant to seeking therapy, acknowledge it’s not your job to make them take the step. In addition, you can’t be responsible for managing every aspect of their day-to-day life. By taking time to practice self-care and establish boundaries, you actually put yourself in a better position to help your loved one and everyone around you.